PAULINE WYATT (PT) – Physical Therapist, NPI 1205981404

PAULINE WYATT (PT) is a healthcare provider. based in Saint john, Indiana. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT. They hold a License No. 005293 (CT). The NPI Number for PAULINE WYATT (PT) is 1205981404

Main info

Female
31 Years Of Experience
Name
PAULINE WYATT (PT)
NPI
1205981404
Phone
(219) 365-6553
Address
8259 WICKER AVE
Enumeration Date
25 January 2007
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8605726657
Graduation Year
1995 (31 years ago)
PAC ID
1456457225
Group Practice PAC ID
5496193658
Professional Enrollment ID
I20070511000200
Address ID
CT063351541GA1666X12XX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,335 PHYSICAL THERAPIST IN PRIVATE PRACTICE in CT

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Provider Addresses for PAULINE WYATT (PT)

  • 8259, Wicker Avenue, St. John, Lake County, Indiana, 46373, United States

    SAINT JOHN, IN 463738878

    Phone: (219) 365-6553

    Type: Mailing

  • Parkway, Tramore, Waterford City Metropolitan District, County Waterford, Munster, Ireland

    WATERFORD, CT 063851234

    Phone: (860) 447-0417

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2007-05-11

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20070511000200IPhysical Therapist In Private PracticeCTTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 46373)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5496193658View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeMA
Physical Therapist In Private PracticeCT
Physical Therapist In Private PracticeRI
Physical Therapist In Private PracticeCT

Reviews

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Frequently asked questions

What NPI should I save for PAULINE WYATT (PT)?
Save NPI 1205981404 if you need a stable reference for PAULINE WYATT (PT).
Is PAULINE WYATT (PT)'s NPI currently valid?
The extract we use shows PAULINE WYATT (PT) as active.
What kind of provider is PAULINE WYATT (PT)?
The page reflects Physical Therapist for PAULINE WYATT (PT). Clinical services aligned with this taxonomy classification.
Does PAULINE WYATT (PT) practice in Indiana?
You will see Saint John, Indiana on file for PAULINE WYATT (PT) alongside any extra practice locations.
Is PAULINE WYATT (PT) a real provider?
This page reflects official NPPES data for NPI 1205981404. Always confirm identity and privileges with the practice and licensing boards.

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